Healthcare Provider Details

I. General information

NPI: 1093021651
Provider Name (Legal Business Name): BERGERON MOBILE HEALTH SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2010
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 POND DR
THIBODAUX LA
70301-8444
US

IV. Provider business mailing address

275 POND DR
THIBODAUX LA
70301-8444
US

V. Phone/Fax

Practice location:
  • Phone: 985-870-1637
  • Fax:
Mailing address:
  • Phone: 985-870-1637
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number StateLA

VIII. Authorized Official

Name: BARRY JAMES BERGERON
Title or Position: OWNER/CEO
Credential:
Phone: 985-870-1637